Diagnostic value of vietnamese smell identification test in Parkinson's disease.

INTRODUCTION: The Vietnamese Smell Identification Test (VSIT) has been validated in determining olfactory dysfunction in the Vietnamese population; however, its value in diagnosing Parkinson's disease (PD) has not been established. METHODS: This case-control study was conducted at University Medical Center HCMC, Ho Chi Minh City, Vietnam. The study sample included non-demented PD patients and healthy controls (HC) who were gender- and age-matched. All participants were evaluated for odor identification ability using the VSIT and the Brief Smell Identification Test (BSIT). RESULTS: A total of 218 HCs and 218 PD patients participated in the study. The median VSIT and BSIT scores were significantly different between PD and HC groups (VSIT, 5 (3) vs. 9 (2), P < 0.0001; BSIT, 6 (3) vs 8 (2), P < 0.0001). Using the cut-off of <8 for correct answers out of 12 odorants, the VSIT had higher sensitivity (84.4%) and specificity (86.2%) than those of the BSIT (sensitivity of 81.7% and specificity of 69.3%) for the diagnosis of PD. The area under the curve (AUC) value was greater for the VSIT than for the BSIT (0.909 vs 0.818). The smell identification scores were not significantly correlated with disease duration, disease severity, or LEDD (all p > 0.05). CONCLUSION: The VSIT can be a valuable ancillary tool for supporting the diagnosis of PD in Vietnam. Olfactory dysfunction in PD was unrelated to the disease duration and severity. The VSIT can be applied to improve the accuracy of clinical PD diagnosis.

Normative data for the Vietnamese smell identification test.

Introduction: The 12-item Vietnamese smell identification test (VSIT) has been developed to evaluate the olfactory function of the Vietnamese population. This study aimed to investigate the normative value of the VSIT in different age groups and sexes. Methods: This cross-sectional study was conducted at Ho Chi Minh University Medical Center, Vietnam. All participants were evaluated for odor identification ability using the VSIT. We included healthy participants aged 18 years or older with no history of olfactory disturbances. Results: A total of 391 healthy volunteers were recruited with a mean age of 45.80 years (SD: 17.62; range: 18-86; female: 63.4 %). The tenth percentile of scores on the 0-12 VSIT scale was 8.3 in participants aged 18-29 years, 9.0 in 30-39 years, 8.0 in 40-49 years, 7.8 in 50-59 years, 7.9 in 60-69 years and 6.0 in over 70 years. Young adults (18-39 years old) had better olfactory identification ability than older adults (over 50 years), p < 0.001. There was a significant main effect of sex on VSIT score (p = 0.02), suggesting that females outperformed males. Sensitivity to 8 odors were negatively correlated with age: lemon, garlic, banana, coffee, mango, guava, apple and watermelon (p < 0.05 in all cases) whereas four odors were age-independent including orange, fish sauce, soy sauce, and fish. Conclusion: Normative data provide guidance for assessing individual olfactory function. However, there were significant sex and age effects on olfactory identification scores on the VSIT. Therefore, future studies should be conducted to better adjust for those confounders mentioned above.

Cervical dystonia: Injecting botulinum neurotoxin into semispinalis capitis improves goose-neck posture.

We describe a patient with goose-neck posture as the presenting form of cervical dystonia. In our case, the bilateral semispinalis capitis muscles were hypertrophic, thick, and overactive while both splenius capitis and sternocleidomastoid muscles were normal. In this single case experience, we demonstrated that the semispinalis capitis muscle may play a primary role in causing a goose-neck posture and the observed forward sagittal shift may be a compensatory or overflow activity of neck flexor muscles. Therefore, botulinum toxin injection to the semispinalis capitis muscles can be considered in the management of patients with goose-neck posture.

Validating the Vietnamese version of wearing - Off 19 questionnaire for patients with Parkinson's disease.

BACKGROUND: One of the most common complication of the progression of Parkinson's disease (PD) is the wearing off phenomenon. A validated Vietnamese version of Wearing off 19 (WO19) questionnaire is necessary to optimize the Vietnamese PD treatment. OBJECTIVES: This study was undertaken to determine the quality attribute of the questionnaire as a tool for early detection of wearing off (WO) in Vietnamese population with PD. We also sought the relationship between the WO phenomenon and factors concerning the clinical condition and course of the disease. SUBJECTS AND METHODS: This is an observational, cross-sectional study. Patients diagnosed with PD under dopaminergic treatment came to University Medical Center Ho Chi Minh city for a regular appointment were sequentially asked to complete the Vietnamese WO19 questionnaire. A neurologist specialized in movement disorders assessed the patient and determined whether he had experienced wearing off or not. The questionnaire results were then compared to the clinical opinion of the expert which is considered the gold standard for diagnosing wearing off. The reliability of the questionnaire is evaluated by Cronbach'α and Cohen's kappa coefficient. The validity is measured by the sensitivity and the specificity of the instrument compared to the gold standard. The multivariate logistic regression analysis is used to learn the relations of associated factors and wearing off phenomenon. RESULTS: 98 patients with the mean age 59.12 ±â€¯10.99 have joined our study; 58.2% are male; and the mean disease duration is 6.32 years. The Vietnamese version of the WO19 questionnaire has a good reliability (Cronbach'α = 0.778) and the agreement with the expert assessment (the diagnostic accuracy) is at a substantial level (Kappa value = 0.618). The sensitivity and specificity of the questionnaire resulted 89.28% and 71.43% respectively. The multivariate logistic regression analysis revealed a long disease duration (≥6 years) (OR: 16.96; 95% CI: 2.17-132.57; p = 0.007), a high daily levodopa dosage (≥400 mg/day) (OR: 6.31; 95% CI: 1.36-29.23; p = 0.019) and high score of MDS-UPDRS part IV (≥4) (OR: 15.36; 95% CI: 2.13-110.58; p = 0.007) were independent predictive factors for wearing off in Vietnamese PD patients. CONCLUSIONS: Vietnamese - WO19 is a reliable and effective tool which should be used in clinical practice for early detecting PD patients with wearing off.